Faculty of Health and Social Care, Edge Hill University, Ormskirk, UK; Liverpool Head and Neck Centre, Liverpool University Hospital Aintree, Liverpool, UK.
Institute of Nursing and Health Research, Ulster University, Newtownabbey, Co. Antrim, UK; South Eastern Health and Social Care, Upper Newtownards Road, Belfast, UK.
Int J Oral Maxillofac Surg. 2021 Jul;50(7):865-872. doi: 10.1016/j.ijom.2020.11.001. Epub 2020 Nov 26.
Fatigue has a profound impact on health-related quality of life (HRQOL). The aim of this study was to describe the clinical characteristics and HRQOL of head and neck cancer patients who raised the issue of fatigue on the Patient Concerns Inventory (PCI) at their review consultation. Eight consultants were randomized to use the PCI as part of a cluster-controlled trial. Patients also completed the University of Washington Quality of Life version 4 (UWQOL), EQ-5D-5L (EuroQol Group), and Distress Thermometer questionnaires. The study included 140 patients who attended clinics at a median of 108 (interquartile range 70-165) days after the end of treatment. The PCI item 'fatigue' was the sixth most commonly selected, by 29% (n=40). Those with advanced tumours were more likely to have selected the item (30/84, 36% vs 10/56, 18%; P=0.02), as were those treated with radiotherapy±chemotherapy (34/87, 39% vs 6/53, 11%; P<0.001). The PCI fatigue group reported significantly worse overall quality of life, social-emotional and physical function composite scores (UWQOL), Distress Thermometer, and EQ-5D-5L. PCI fatigue was common in those with sleeping, nausea, mood, depression, mobility, breathing, and energy level concerns. In conclusion, given the problems associated with fatigue, it is appropriate to screen and seek interventions that might help patients address this.
疲劳对健康相关生活质量（HRQOL）有深远的影响。本研究旨在描述在就诊时通过患者关注量表（PCI）提出疲劳问题的头颈部癌症患者的临床特征和 HRQOL。八位顾问被随机分配使用 PCI 作为一项聚类对照试验的一部分。患者还完成了华盛顿大学生活质量量表第 4 版（UWQOL）、EQ-5D-5L（欧洲五维健康量表）和苦恼温度计问卷。该研究纳入了 140 名患者，他们在治疗结束后中位数 108 天（四分位距 70-165 天）就诊。PCI 项目“疲劳”是第六个最常被选择的项目，有 29%（n=40）的患者选择了该项目。肿瘤晚期患者更有可能选择该项目（30/84，36% vs 10/56，18%；P=0.02），接受放化疗治疗的患者也更有可能选择该项目（34/87，39% vs 6/53，11%；P<0.001）。PCI 疲劳组报告的总体生活质量、社会情感和身体功能综合评分（UWQOL）、苦恼温度计和 EQ-5D-5L 明显更差。PCI 疲劳组的睡眠、恶心、情绪、抑郁、移动、呼吸和精力水平问题更常见。总之，鉴于疲劳相关问题，进行筛查并寻求可能有助于患者解决该问题的干预措施是恰当的。
